Leadership and Ethics during Challenging Times

We live and work in times that are very challenging, and ever-changing to say the least. We also live and work in times in which our ethics seem to be challenged on a regular basis.

One just has to open any newspaper, magazine, or blog, or watch any television program, to read or hear about the many ethical challenges facing citizens across our nation and around the world. Within healthcare ethics and compliance, there are monthly, weekly, and even daily occurrences of ethical collapse resulting in fraud, waste, and/or abuse. Whether it’s overutilization of medical services, lack of medical necessity, gaming the system, or even upcoding resulting in improper payments and reimbursement, these issues persist.

With all these ongoing ethical challenges, we need strong leadership. But what is “leadership?” I can recall many interviews I conducted with employment candidates, during which this question was asked. After a year or two, I started to gather the responses, and overwhelmingly, I found that “honesty and truthfulness” were the most common answers. This led me to think that leaders need to possess these qualities through their communications, actions, and company/department goals.

So, what is your own definition of “leadership?”

According to Wikipedia, leadership is “the ability of an individual or organization to ‘lead’ or guide other individuals, teams, or entire organizations.”

Another definition comes from Forbes, through Kevin Krause, who says that “leadership is a process of social influence, which maximizes the efforts of others, towards the achievement of a goal.”

What isn’t mentioned here is the word “good” or “bad” in front of “leadership” or “leader,” which of course would make the definition change. Imagine now what a “good leader” and what a “bad leader” is. Ethics, integrity, and truthfulness usually come to mind immediately.

When we think about and discuss leadership and ethics, we also need to look at values. Values can include any of the following, which experts in this subject strongly believe in:

Authenticity

Achievement

Adventure

Authority

Autonomy

Balance

Beauty

Boldness

Compassion

Challenge

Citizenship

Community

Competency

Contribution

Creativity

Curiosity

Determination

Fairness

Faith

Fame

Ethical

Friendships

Fun

Growth

Our values should be accessed and reviewed annually due to the many challenges we continually face. There is some good information and tools on the Internet to assist with value assessing.

During the most recent American Health Information Management Association (AHIMA) annual convention, held from Sept. 22-26 in Miami Beach, I spoke about ethics in coding, coupling it with a discussion of leadership in our challenging and ever-changing healthcare environment. During this educational session, we discussed what leadership is and looked at several recent compliance issues and False Claim Act (FCA) violations. We then focused on individual experience regarding unethical or noncompliant behavior in the workplace and created a personal list of values. Through group participation, we also did some brainstorming on what might be next for the health information management (HIM) profession, in regard to leadership and ethics.

So, where do we go from here? Well, it is critical that each and every HIM, coding, and clinical documentation improvement (CDI) professional read over their codes of ethics for their organization, as well as the AHIMA Standards of Ethical Coding. Even share and discuss these documents with your staff. Bring any ethical or compliance concern to leadership, use the proper reporting channels, and promote this practice.

Reflect on your leadership traits and the leadership traits of those above you, keeping in mind the many challenges we all face. Then, you should conduct a values assessment, listing around 20 values and selecting five that you believe you have – and then reflect on those. Also, conduct the values assessment with staff and interview them regarding any concerns they have about ethics and compliance.

Having open and regular communication within a department, company, or organization can make a great difference regarding the perception of management and leadership staff. Of course, attending some leadership educational seminars or programs can also add value to your role, both as a member of a group and individually as a leader.

I encourage all those in healthcare to look closely at the leadership and value traits they have, and also of those with whom they work. We need strong morale, and ethical guidance each and every day, and our leaders need to be there to provide and encourage this through their actions.

Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICd-10-CM/PCS Trainer, is a 40-year HIM coding professional, focusing on compliance and ethics. She is a member of the ICD10monitor editorial board, and a popular panelist on Talk Ten Tuesdays.

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